To function correctly, the spine and vertebrae should be free to move throughout their normal range of motion. Spinal function decreases with age and medical condition. With function loss the spine stiffens, excessive wear and tear, stretched ligaments, joint degeneration and pain results. The restoration of function increases and improves spinal range of motion, flexibility and joint mobility.
To restore or improve spinal function, a physician, physical therapist, chiropractor or other health care professional may recommend spinal mobilization. Traditionally spinal mobilization is preformed manually and physical therapists currently employ a number of manual techniques. The most relevant is Maitland mobilization, where the thumbs and hands along with various movements and positioning of the patient effect a mobilizing force upon pairs of vertebrae. These techniques, however, fall far short of focused, precise, joint by joint, gentle, passive and progressive mobilization of the entire spine. As illustrated in FIG. 1, if a force or gentle pressure is applied over the points marked “A” and then over the points marked “B” the vertebral articulation or joint may be rocked or counter rotated back and forth through its normal range of motion successfully delivering mobilizing forces and effecting spinal mobilization. A physical therapist or other health care professional could attempt to apply this pressure with their thumbs or hands however, because the joints of the spine are much bigger and tougher than the therapist's fingers and hands, many therapists would find it difficult if not impossible to apply this technique manually.
Moreover, in addition to the spine's vertebral components, the musculature and reflex muscle activity of the spine is important to back function. Physical therapists believe that with aging and/or chronic back pain and the subsequent development of protective postural responses, guarding, back stiffness and loss of function, the paraspinal muscle groups loose their optimal reflex activity. Just as a patellar reflex will degrade if a leg is immobilized for a long period, so muscle reflexes associated with the stiff or immobile spinal joints degrade. The restoration of these reflexes through repeated and progressive stimulation also contributes to improving spinal function and back health.
Unassisted manual spinal mobilization is difficult, because the forces necessary for manual spinal mobilization requires the application of excessive and uncomfortable pressure from a practitioner's fingers or hands applied to the spinal joints, often for an extended treatment period. Thus, automatic devices have been suggested as a way to assist a practitioner (e.g., a physician, chiropractor, physical therapist, etc.) in mobilizing spinal joints. Unfortunately, most such devices lack the precise control that is beneficial to treatment of spinal joints and cannot adequately reproduce the touch of the practitioner's hand. For example, most known applicators do not allow sufficient control of the rate that the spinal joints are mobilized, or the force used to mobilize the spinal joints. Furthermore, most tools inhibit the practitioner's ability to sense the response of the back and spine to the treatment. Most currently available physical therapy tools provide only crude control (if any) of the rate of application of pressure and the manner in which pressure is applied.
For example, U.S. Pat. No. 5,092,316 to Taylor et al. describes a physical therapy device for treating spinal disorders and represents the state of the art for such physiotherapy tools. This device has reciprocating actuators with feet that can be applied to a pair of vertebra for treatment. The device may include pneumatic logic controlled by an adjustable choke so that the rate at which the actuators are moved is controlled by manually adjusting the choke. U.S. Pat. No. 5,192,316 is essentially a percussion device with two pairs of pistons operating 180° out of phase. One pair of pistons delivers blows over the points marked “A” marked on FIG. 1. As this pair is retracted, the second pair delivers blows over the points marked “B”. The blows must, of necessity, be very light. Heavy blows would be injurious. Other examples of existing physical therapy devices may be found in U.S. Pat. Nos. 5,653,733 and 5,262,615 to Keller et al., and U.S. Pat. No. 6,503,211 to Frye. All of the patents listed above are herein incorporated by reference in their entirety.
Ideally, a physical therapy tool for use in treating a spine acts as a virtual extension of the practitioner's hands, allowing the practitioner to easily operate the tool when treating a subject (e.g., adjusting the way that the pressure is applied by the tool including the rate that pressure is applied), and to detect the response of the subject while using the tool. In contrast, most commercially available physical therapy tools permit only limited control, and also inhibit feedback between the subject and the practitioner using the tool.
Precise control is necessary because it allows the practitioner to control the application of treatment. For example, spinal treatment is often difficult to localize. Loss of flexibility may be difficult to correct because interactions between vertebrae are complex, and correction of a problem in one area may exacerbate a problem in another area, or may create a new problem. Further, correction of the new problem (or new problem area) can lead to the reappearance of the original problem. In many cases, effective treatment should be properly localized and scaled based on the nature of a particular subject's spine. A practitioner treating a subject's spine may therefore rely on his or her experience, as well as on feedback from the subject. Furthermore, manipulation applied to specific vertebra may also cause movement of adjacent vertebra. Thus, it is often difficult to increase the intravertebral mobility other than over a substantial period of treatments, using conventional manipulative techniques.
Thus, it would be desirable to provide tools, methods, procedures and kits that overcome many of the difficulties described above, and enable a practitioner to effectively treat the spine of a subject.